Chicago Christian Counseling Center Inc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

CHICAGO CHRISTIAN COUNSELING CENTER INC

Practice address

15127 S 73Rd Ave
G
Orland Park, IL 60462-4398

Phone

(708) 845-5500

Fax

(708) 845-5505

NPI assigned

May 12, 2006

Last updated

Sep 25, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Amanda Kuba

Title

Billing Manager

Phone

(708) 845-5500

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

Enrollment records 2

Tax ID family

Chicago Christian Counseling Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Chicago Christian Counseling Center

  • Clinical Psychologist
  • Schereville, IN
  • NPI 1053445239
  NPD tax ID

Locations

Practitioners 89

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Darlene Katrina Alexander, LCPC,NCC,MA

  • Professional Counselor
  • Tinley Park, IL
  • NPI 1730402884
  Medicare reassignment Care Compare group NPD
• Daniella J Appiagyei

  • Professional Counselor
  • Orland Park, IL
  • NPI 1821420415
  Medicare reassignment Care Compare group NPD
• Maria Regina Blackburn, MSW

  • Clinical Social Worker
  • Orland Park, IL
  • NPI 1699138016
  Medicare reassignment Care Compare group NPD
• Joyce M Bocanegra, LCPC

  • Professional Counselor
  • Orland Park, IL
  • NPI 1558506766
  Medicare reassignment Care Compare group NPD
• Debra Crockett

  • Social Worker
  • South Holland, IL
  • NPI 1538698071
  Medicare reassignment Care Compare group NPD
• Aimee Echevarria

  • Clinical Psychologist
  • New Lenox, IL
  • NPI 1366745812
  Medicare reassignment Care Compare group NPD
• Laura J Goossens

  • Clinical Social Worker
  • Orland Park, IL
  • NPI 1467833814
  Medicare reassignment Care Compare group NPD
• Leah A Johnson

  • Clinical Social Worker
  • Orland Park, IL
  • NPI 1467229583
  Medicare reassignment Care Compare group NPD
• Katherina Krentkowski, LCPC, LMHC

  • Mental Health Counselor
  • Oak Brook, IL
  • NPI 1285793463

  IN

  Medicare reassignment Care Compare group NPD
• Adrienne Lambert

  • Professional Counselor
  • Matteson, IL
  • NPI 1225696958
  Medicare reassignment Care Compare group NPD
• Deborah A Mach

  • Professional Counselor
  • Shorewood, IL
  • NPI 1558978189
  Medicare reassignment Care Compare group NPD
• Deborah A Mitchell, LMFT

  • Marriage & Family Therapist
  • Orland Park, IL
  • NPI 1922330232

  IN

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1083664510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15127 S 73RD AVE",
            "address_2": "G",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624398",
            "telephone_number": "800-361-6880",
            "fax_number": "708-845-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15127 S 73RD AVE",
            "address_2": "G",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624398",
            "telephone_number": "708-845-5500",
            "fax_number": "708-845-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO CHRISTIAN COUNSELING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "KUBA",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "708-845-5500"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Chavka, SLP
• Shih-Hua Chen, MS, ATC, PA-C
• Julie Chew, PA
• Samantha Chiariello, PSYD
• Chicago Anti-Aging Institution 2
• Chicago Hearing LLC (Miracle Ear)
• Chicago Medical Group, Inc.
• Chicago Neurobehavior Specialists
• Chicago Oral Medicine
• Chicago Rehabilitation Consultants LLC

• Clinical Social Worker in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.